What is Critical Care in Nursing
Critical care nursing is a specialized field dedicated to the care of seriously ill patients at risk of life-threatening medical conditions. These patients often require close assessments and interventions to support vital organ function and prevent deterioration. While intensive care units (ICUs) in hospitals are a common component of critical care, there are also specialized units like neonatal, cardiac, and trauma ICUs. This blog offers a comprehensive guide to critical nursing care.
Roles and Responsibilities of Critical Care Nurses
Critical care nursing involves close collaboration with medical professionals. In essence, critical care nurses assess, diagnose, and oversee seriously ill patients while tending to their basic needs. They are highly trained to diagnose and care for patients of all ages recovering from life-threatening medical conditions or accidents.
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Typical tasks of an ICU nurse include evaluating a patient’s condition, initiating treatment, monitoring vital signs, interacting with patients and families, administering IVs, and dispensing medication. ICU patients often require multiple IV infusions.
Those considering a career in critical care nursing should be aware of its rewarding yet challenging nature. From a patient’s initial evaluation to end-of-life care, critical care nurses play a pivotal role in life-saving procedures and treatments. Providing care to patients in their most critical condition requires a passionate and special type of nurse.
Varieties of Critical Care Units
Aspiring critical care nurses should recognize the diverse categories within this field. So, what are the different types of critical care units?
– Pediatric Intensive Care Unit (PICU):
Nurses in this unit care for seriously ill or injured children, striving to stabilize their condition. Average annual salary is around $65,000.
– Postoperative Care Unit:
These nurses assist patients in pain following surgery, demanding strong diagnostic skills and anesthesiology knowledge. Average annual wage is $60,000.
– Flight Nursing:
Flight nurses care for seriously ill patients requiring air travel for better care or specific destinations. Typical income for travel nurses is $60,000.
– Neonatal Intensive Care Units (NICU):
Specializing in newborns with potential life-threatening conditions, these nurses collaborate with doctors. Average annual pay is approximately $65,000.
– Cardiothoracic Intensive Care Unit:
Nurses in this unit manage individuals with various illnesses and heart-related issues, often handling two to three patients. Some nurses earn substantial incomes, occasionally reaching $170,000.
– General Intensive Care Unit:
Nurses here deal with seriously ill patients, constantly monitoring and advocating for their health. Average annual compensation is around $75,000.
– Neuro ICU:
Nurses in this unit attend to patients with sleep, communication, and sexuality disorders, with an average annual wage of $70,000.
– Emergency Room:
Nurses in this unit provide care to patients requiring urgent attention, often working long hours. They promptly evaluate patients and assign them to appropriate doctors, with an average yearly income of about $65,000.
Ethical Challenges in Critical Care Nursing
Critical care nurses grapple with ethical dilemmas regularly, whether related to professional ethics or assisting patients and families in resolving their own ethical concerns. What are some ethical dilemmas in critical care nursing?
This topic explores major ethical dilemmas faced by critical care practitioners. Topics include advance directives, palliative care, and withdrawal of care.
An Ethical Dilemma Example
Consider a patient unable to breathe independently due to a lung injury. He requires frequent resuscitation and continuous use of a breathing machine to sustain life. Despite his awake and conscious periods, he requests to be a do-not-resuscitate (DNR) patient during an orientation session.
His sister disputes this decision, asserting his lack of competence and threatening legal action if DNR care is approved. She advocates for every possible effort to ensure his survival, even though his heart has stopped several times before.
After an ethics committee assesses his competence, the patient is deemed capable of making decisions. He becomes a DNR patient and passes away peacefully shortly after.
Palliative Care Choice
In the mentioned case, the patient opted for palliative care rather than discontinuing the ventilator after choosing DNR status. As a critical aspect of nursing, palliative care aims to minimize suffering and ensure a painless death for patients.
Patients may receive sustenance but not life-saving interventions like dialysis, surgery, or CPR, unless for relief rather than treatment, aligning with their preferences.
Withdrawal of Care
Building upon the aforementioned situation, withdrawing care within the realm of critical care nursing occurs when a patient chooses to discontinue life-sustaining measures, such as ventilator support. This scenario is common in individuals whose hearts continue to beat despite being brain dead.
In such instances, life-supporting interventions, including the ventilator, are ceased, allowing the patient to pass away peacefully.
This occurrence is frequently observed in intensive care units. When a patient is critically ill, certain family members may seek to prolong life through all possible means. Conversely, other family members or even the patient may opt for a dignified end. In such situations, a healthcare power of attorney or advanced care directive can be immensely valuable.
Should the patient lack such directives, the hospital’s ethics board must decide the course of action.
Advance Directives
An advance directive is a written declaration signed by the patient with the presence of two non-family member witnesses. It outlines the patient’s preferences for treatment in the event of terminal illness or loss of decision-making capacity. In critical care nursing, advance directives are essential as they designate a representative to make decisions on the patient’s behalf.
Healthcare personnel refer to this statement to ascertain the patient’s wishes and ensure their implementation. Living wills and medical powers of attorney are the two types of advance directives.
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Levels of Critical Care
You might wonder about the hierarchy of critical care. The “Comprehensive Critical Care” report released in 2001 by the UK Department of Health delineates the primary levels of care, ranging from Level 1 to 3.
– Level 1:
This constitutes ward-based care for patients not requiring organ support. They might necessitate oxygen via a mask or intravenous (IV) treatment.
– Level 2:
High-Dependency Units (HDUs) fall under this category. Patients here require single organ support, like renal hemofiltration or inotropes, but not mechanical ventilation. One nurse is typically assigned to two patients.
– Level 3:
Intensive care units fall into this level. Patients need support for two or more organs or require mechanical ventilation alone. Each patient is typically assigned one nurse, and a doctor is usually on duty around the clock.
Critical Care Nurse Responsibilities
Similar to other registered nurses, critical care nurses provide essential medical services including monitoring and assessing a patient’s condition, administering medications, addressing any condition changes, and utilizing specialized diagnostic tools.
A significant distinction between critical care nursing and other nursing disciplines lies in patient load. Due to the delicate nature of their patients’ conditions and the extra care required, critical care nurses tend to oversee fewer patients during a shift.
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Prompt intervention is vital for them to take necessary actions, as they are at the forefront when a patient’s condition deteriorates. Moreover, those practicing critical care in nursing serve as integral case managers, especially for high-risk patients.
Management in Critical Care Nursing
In the hospital context, the multifaceted challenges demand varied decisions to yield diverse outcomes. Critical care nursing, within its dynamic environment, serves as an ideal stage for the assessment and treatment of seriously ill patients.
This fast-paced field necessitates addressing numerous concerns and presenting solutions. Be it in cardiac critical care, intensive care units, emergency rooms, or pediatric critical care.
Concluding Thoughts
Critical care nursing is both demanding and rewarding, requiring specialized knowledge, skills, and compassion. Nurses in critical care units tend to critically ill and injured patients, often in situations where their survival hangs in the balance. If you seek expert guidance or answers to queries, consider visiting usanursingpapers.com.
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